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My teens boys are in their phase when the peer pressure is remarkable. They are under the impression that they have to be reliable and to compete for their friends and their own gain. It is very depressing to see them spend so much time into this game, and it may not affect them directly or academically but I am trying to stop this abuse as a way to intervene that nothing similar would happen to them.

Yes we see this frequently. Sadly the men dont always seek help. They try to solve it on their own. I often ask women describing relationship issues, especially alchol abuse, if their partner might be depressed and they say yes. The women can recognize the dual diagnosis. Men are also often impacted by early trauma.

Helpful info, I provide onsite services in a major corporation with engineers and other professional males. I saw this recently with someone using alcohol to deal with his separation from his family. Once he addressed the alcohol use he allowed himself to recognize depression and begin antidepressant meds. Now 6 weeks later he is no longer angry, demonstrates productive thinking processes and positive thoughts towards his contribution to the downfall of his marriage. Thanks for the terms overt and covert to apply to his experiences.

I was married to my X for 23 years. I realized something was wrong and I suspected he was depressed. He was withdrawn, had to drink beer every day, would not even talk to me his spouse. Over the years he never spoke about childhood memories unless pressed to do so. He only had 2 memories he would share with me and they were both negative. I’m convinced now he was depressed. Thanks! This was very interesting.

Agree with the principle and would look for this in any individual. I really struggle with this “gendered” approach to mental health. It feels very archaic and assumes static archetypes of “manly” and “womanly”…time to update thinking about individuals as unique and move beyond this binary approach. Good concept but the application is broader!

Trained by James Bugental Phd. I have tried in my practice to ‘work close to the resisitance.’ I am now adding mindfulness at a deeper level to help my clients feel that which they resist. When working with substance abusers I try to address the issue of self medication in the 1st or 2nd session to prepare to address co-morbidity.

Thank you, especially for using “overt” and “covert” as describing words. Very helpful. I try to look beyond specific behaviors to ask what said behavior indicates. This information expands the indications.

Depression is so often covered up with a smile. We don’t like other people to think of us as somehow damaged or mentally handicapped. It can mean the difference between getting a job, a new client or even getting an unwanted reputation if you live in a small town. We’re not
supposed to care what other people think, but when a person is depressed it can be difficult to think rationally. Loneliness is a major problem and we don’t want to repel people by coming across as sad and depressed. I personally live happy people and try and surround myself with them :). QED

When depression presents and it is not due to diet, endocrine system, toxins (not a chemical imbalance in brain either – that has long been disproven yet ignored in favor of pharmaceutical industry). When life is overwhelming and seems to suck, it gets named depression, (among other damaging diagnoses including PTSD). It isn’t borderline personality, as someone suggests below, as parts of self are formed to deal with different levels of trauma, overwhelm et al… STOP PATHOLOGIZING PAIN! Depression is normal. This is what is wrong with psychiatry and the way therapists are trained – all that is taught is to diagnose symptoms, not the cause – great therapists get to the root, and in my practice whether men or women, depression is unmitigated stress and trauma. Most people cannot feel why they are depressed because they are so numbed and are lead to believe it is in their brain, but an exceptional therapist shines a light on the root cause, and brings forth clarity and an individuals inner wisdom so they can focus on healing; they as well have positive expectancy for them, and join with their client so that they can heal.

I have been told by family that depression runs in our family. Paternal grandmother died from alcoholism and her two sons were alcoholics. One committed suicide. A psychologist once told me she thought I had been depressed since my teens.
I recently discovered the idea of childhood emotional neglect and now I wonder if my depression is more nurture than nature. It doesn’t help the symptoms to know either way.

I saw this often in my practise. The self medication was there but there was this sense of anger. Difficult for men to describe what they felt or acknowledge but once they could give it a name it often helped. At times the feeling was pretty profound.

Yes, withdrawal definitely. Not only from partner/spouse but from children too. There are men who don’t talk to their kids for half a decade.
Another area which is common and wasn’t mentioned is workaholism. “I’m not depressed or withdrawing from my family, I’m just really busy.”

Is this a form of depression? Dreadfully low physical energy for no obvious reason, wanting to close the eyes whenever possible and not look at the world, closing the eyes when listening on the telephone, sense of sinking into “darkness” at some deep level, personal interpretation that one is slowly dying.

Some of the behaviors he labels as defensive could also be borderline behaviors; the compulsive acting out, rages, splurge spending, etc……. been thinking lately though how borderline issues can so easily exist with depression and or bipolar stuff. Not so sure if he’s right about the differences in shame in how men and women experience depression. While it may be more socially acceptable for women to express their feelings, because this culture is so “happiness” focused, whenever I feel lousy, I also feel a sense of shame, that I “should” be able to control my emotions and “choose” happiness.

Nice short overview. For whatever reason NICABM has left out the historical context. The intro & video are presented as something new, a new concept or intervention. In fact, covert depression has been standard in graduate school teaching and in practice since Terry Real popularized it 20+ years ago.

Thanks! Wondersfull conceptualzation about why it is harder for men to acknowledge their depression! These defense patterns seem to fit perfectly within the framework of experiential avoidance, as it is conceptualized in ACT or dysfunctional emotion regulation in DBT. So I’ll integrate these insights within such frameworks. Another form of “covert” depresssion is the anxious depression as in comorbid GAD and MDD (Dysthymia). These are depressed people who never stay over in bed and who will complain about other anxiety disorders, insomnia, sexual disorders, irritability, interpersonal conflicts and so on, but never about being or feeling depressed. Happy new year!!

Thanks! Wondersfull conceptualzation about why it is harder for men to acknowledge their depression! These defense patterns seem to fit perfectly within the framework of experiential avoidance, as it is conceptualized in ACT or dysfunctional emotion regulation in DBT. So I’ll integrate these insights within such frameworks. Another form of “covert” depresssion is the anxious depression as in comorbid GAD and MDD (Dysthymia). These are depressed people who never stay over in bed and who will complain of other anxiety disorders, insomnia, sexual disorders, irritability, interpersonal conflicts and so on, but never about being or feeling depressed. Happy new year!!

Ignacio – “Thanks! Wondersfull conceptualization about why it is harder for men to acknowledge their depression! These defense patterns seem to fit perfectly within the framework of experiential avoidance” – great observation, and adding to this, I would say the emulated behaviors among men that are the aggressive reactions to their own distress can’t justify the fact that they are themselves resisting to receive help. This is a taunting and misfortunate depressive cycle due to anxiety in itself.

Thank you for bringing this forward. I’ve been recommending Terry Real’s book “I don’t want to talk about it” for several years. Men who are highly resistant to accepting that depression is a real issue for them, I ask them to either buy the book or to listen to it in audio format. I often find they are more resistant to reading it than listening to it. It has turned lives around. I’m currently working with a 32 year old man who came in because his mother was pleading with him to stop alcohol, cocaine, womanizing, and overspending. He was labelled with ADHD in school when he was young, and struggles to read. He was resentful of his mother’s interference, and determined there was NOTHING wrong with him. I told him he might see it that way, but if he could just listen to this book, before we close his file. He got the audiobook and is changing his life around. He has a long way to go (only 30 days sober/abstinent), but at least now he is starting to have better self awareness, and recognizes his childhood and most of his life has been difficult. It’s so rewarding to see him turn this corner!